Renal transplant waiting list mortality in COVID era: is it advisable to halt transplant activity?

Introduction: Kidney transplantation is the treatment of choice for end-stage renal disease (ESRD). Since March 2020, transplant activity in Mexico has been affected due to the COVID-19 pandemic.

Objective: The aim of the study was to determine the impact on mortality of patients on the waiting list (WL) for cadaveric donor kidney transplantation in a referral hospital in Yucatán, due to suspension of activities due to the pandemic.

Material and methods: Patients over 18 years of age on the waiting list for kidney transplantation at this hospital. In the event of a patient's death, the cause was investigated, especially if it was associated with COVID-19. A two-tailed p ≤ 0.05 was considered significant in all analyzes.

Results: The odds ratio (OR) of death from COVID-19 in a patient with ESRD in the WL in 2020 was OR = 5.04 (95% CI: 1.65-7.14, p = 0.023). The OR of dying with ESRD in the WL with a delay in the follow-up visits was OR = 6.59 (95% CI: 2.7-16.28, p = 0.008).

Conclusion: The probability of death of a patient with ESRD with delayed follow-up visits and transplant retention is statistically higher than the probability of death from COVID-19.